Men's Health

Refinements to PSA Testing May Save Lives

Changing the way the PSA screening test is scheduled could help more men find prostate cancer early, as well as reduce the number of unnecessary biopsies.

PSA stands for prostate-specific antigen, a blood protein that helps doctors screen for prostate cancer. Higher PSA levels may indicate that a man has prostate cancer - or is at higher risk for the disease.

Current guidelines from the American Cancer Society suggest that men discuss the PSA test with their doctor when they turn 50. In contrast, the American Urological Association recommends that men discuss PSA screenings with their doctor no later than age 45, and preferably at age 40.

Different age suggested

The results of several recent studies, however, argue that men should be screened between ages 44 and 50 to determine a base line for how likely they are to develop cancer later in life. A PSA level of 1.5 or greater before age 50 would point to the need to have a follow-up screening in two years or as recommended by their doctor.

And men older than 60 with low PSA levels may not need follow-up testing because their risk for developing prostate cancer is minimal.

The study findings suggest that some men may only need three PSA screenings: the first between ages 44 and 50, the second between ages 51 and 55, and, if their PSA levels are still low, a third at age 60. Men with higher PSA levels would need more screenings.

Change in focus

"Instead of testing all men each year or every two years, screening and surveillance efforts can be focused on early detection of prostate cancer in those men who are found to be at high risk of death from the disease," says Hans Lilja, M.D., lead author of one study and researcher at Memorial Sloan-Kettering Cancer Center in New York City.

Another study of PSA looked at how fast PSA levels rose by looking at PSA velocity. Adding this measurement to the standard PSA screening may help find more aggressive tumors, the researchers say.

Always talk with your health care provider to find out more information.

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July 2011

Diagnosing Prostate Problems

If you have symptoms such as difficulty urinating that may indicate a prostate problem, your doctor will try to figure out why. He or she will want to rule out prostate cancer.

Here are several tests your doctor may use:

Digital rectal exam (DRE). During a DRE, your doctor inserts a gloved, lubricated finger into the rectum in order to feel the prostate. He or she will check for hard or lumpy areas. Lumps in the prostate are called nodules.

Prostate-specific antigen (PSA) blood test. PSA levels may rise in men who have prostate cancer; benign prostatic hyperplasia, a noncancerous growth of the prostate; or an infection in the prostate. The test may also measure prostatic acid phosphatase (PAP); PAP levels may rise in men with prostate cancer.

Urine test. This test will check for blood in the urine or an infection.

Other tests. These will look for blockages or other reasons for your urinary problems.

The results of these tests may be enough to rule out cancer. Or the results may require more tests. If your PSA level is only a little high, but your DRE was normal, your doctor may recommend having another PSA test in the near future. If it's still not normal, then your doctor may recommend other tests, such as a prostate biopsy.

Always talk with your health care provider to find out more information.